Oliver Sacks

Oliver Sacks is a practicing neurologist based in New York City. In 2007, he was appointed a Professor of Neurology and Psychiatry at Columbia University Medical Center, and the same year Columbia University designated him its first Columbia Artist. Dubbed "the poet laureate of medicine" by The New York Times, Sacks has written numerous books, most notably compassionate collections of case histories that describe patients suffering from rare disorders of the brain, such as Tourette's syndrome and phantom limb syndrome. These books include The Man Who Mistook His Wife for a Hat, An Anthropologist on Mars, and The Island of the Color Blind. In 1966, as a neurologist at Beth Abraham Hospital in the Bronx, Sacks encountered a group of nearly catatonic patients, survivors of a long-forgotten encephalitis epidemic, whom he treated with the then-experimental drug L-dopa. Astonishingly, after being "frozen" in some cases for decades, his patients "awoke," as Sacks related in his book Awakenings (later made into a Hollywood film starring Robert De Niro and Robin Williams). His latest book, Musicophilia, inspired NOVA's film "Musical Minds."

Q: I have a six-year-old son with autism who loves to listen to Mozart. For him, it has a calming effect, and he just loves it. Over time, should we try to vary the types of classical music that he listens to (i.e., different compositions or different composers)? Or, in your experience, will persons continue to accrue the same mental/emotional benefits from the same pieces of music over long periods of time? Heidi Hill, Marietta, Georgia

Musical taste is highly individual—some people may be calmed by Mozart, others find that Chopin works best. Still others might prefer the Beatles. Familiarity is comforting, and I know that there are certain pieces of music (Bach's Preludes and Fugues, for example) which I can listen to almost daily and never tire of—each time I hear something new. If your son prefers Mozart, by all means stick with it—but you might try to introduce other sorts of music as well.

Q: Do you think we are prewired for our music preferences? I find that folk and Celtic music speak to my soul. My son, who is a music major, is a jazz lover. We each hate each other's preferences. I don't understand why we are so different. My daughter, who is an autistic savant with vocal music, is totally eclectic in her musical tastes. She is able to memorize songs immediately. Anonymous

I suspect that relatively little of our musical preference is prewired. It is more likely that they are formed by the music we are exposed to in our childhood and youth—but also colored by associations, experiences, and emotions which we link to a particular type of music.

Q: Can exposure to music at an early age (3-4 years old) influence or impact a child's current and future language and math ability or skills? Anonymous

In the early 1990s, researchers at the University of California at Irvine designed a series of studies to see whether listening to music could modify nonmusical cognitive powers. They published several careful articles, in which they reported that listening to Mozart (compared to listening to "relaxation" music or silence) did temporarily enhance abstract spatial reasoning. The Mozart effect, as this was dubbed, not only aroused scientific controversy but excited intense journalistic attention and, perhaps unavoidably, exaggerated claims beyond anything intimated in the researchers' original modest reports.

The validity of such a Mozart effect has been disputed, but what is beyond dispute is the effect of intensive early musical training on the young, plastic brain. Takako Fujioka and her colleagues, for instance, examining auditory evoked potentials in the brain, have recorded striking changes in the left hemisphere of children who have had only a single year of violin training, compared to children with no training.

The implication of all this for early education is clear. Although a teaspoon of Mozart may not make a child a better mathematician, there is little doubt that regular exposure to music, and especially active participation in music, may stimulate development of many different areas of the brain—areas which have to work together to listen to or perform music. For the vast majority of students, music can be every bit as important educationally as reading or writing.

Q: I have a keen sense of time, but not pitch. A minor second sometimes sounds the same to me as a major seventh. Yet I wouldn't mistake a 16th-note triplet for a 32nd note. So I wonder: What is known about similarities or differences in the neural mechanisms for pitch distinguishing and time (rhythm) distinguishing? Mehmet Vurkac, Portland, Oregon and Istanbul, Turkey

Pitch and rhythm are processed in different parts of the brain, and their development does not necessarily go together, so one can have an acute tonal sense and a relatively poor rhythmic sense—or vice versa. But usually this is a relative matter. True tone-deafness is rather uncommon (perhaps five percent of the population), though I describe one lady in Musicophilia who cannot distinguish pitches at all—she says that music, to her, sounds like pots and pans clattering on the kitchen floor. Absolute "rhythm deafness" is rarer still—the neural systems which underlie rhythm seem to be more robust and perhaps more widespread in the brain.

Q: Why is it that it is possible to learn to play a tune in only one direction and not instantly be able to play it backwards? Things seem to run in sequence when they are remembered and only in one direction. Are there people who can sequence tonal memory rapidly in either direction? Albert Straub, Westminster, Colorado

Because the logic of the music, its narrative and trajectory, only make sense in one direction—unless the piece is deliberately designed as a musical palindrome. Nonetheless, I suspect that some musicians, and perhaps some musical savants, could reproduce a tune rapidly in either direction.

Q: What is the difference in brain activity between music you like and music you don't like? Vic French, London, Ontario, Canada

Music which produces extreme pleasure, or "chills," activates the reward systems in the brain. But "appreciating" music or finding it "beautiful" are aesthetic value judgements of a more complex sort—and we do not, as yet, have a real science of neuroaesthetics, an idea of what specific brain activity goes with aesthetic sensibility and response.

Q: My sister is 80 years old and recently diagnosed with early Alzheimer's. Is there any data on the effects of music on these people? She is home alone all day and has very little stimulation. Ginny, New Jersey

Q: My grandfather "Zayde" has something called frontotemporal dementia, and his speaking is now difficult to understand and is getting noticeably worse. He doesn't seem to care about anything anymore, his behavior is bland, and he falls asleep in the middle of talking to people. I watched your show tonight, and I saw how you discovered that music helped all these people's brains. Can music help my Zayde's brain too? Eliana, age 11, White Plains, New York

Yes, people with frontotemporal dementia, like those with Alzheimer's or other dementias, will often respond to music, even when they are able to respond to little else. Music, especially familiar music which has personal emotional resonances, can help to orient and organize people with all kinds of dementia. Some people with frontotemporal dementia actually become rather hyper-musical, whistling or singing through much of the day.

Q: I'm doing a paper on the importance of music in everyday life. And I was wondering: Why is music such an effective tool for therapy? Carissa, Grade 11, Ottawa, Ontario, Canada

Music works because everyone responds to it—and in many ways. The rhythm, the beat, is crucial in synchronizing and energizing movement—whether for athletes or people with movement disorders like Parkinson's disease or Tourette's syndrome. And old songs may be recognized and responded to even if there is dementia or deep amnesia—and such music can evoke feelings and memories that are otherwise lost.

Q: Has there been any study showing that music therapy can be helpful in curing or treating epilepsy? Luke Gordon, New York, New York

I quote an example or two in Musicophilia, including one of a patient who has incessant seizures, which only stop when he plays music. So music can have efficacy for people with epilepsy, but for some people, music of a particular sort can actually trigger seizures. So this is a very individual thing.

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